One-year effects of orthokeratology lens wear on objective visual quality and corneal densitometry in adolescents with myopia.

This study aimed to evaluate changes in objective visual quality, corneal wavefront aberrations, and corneal densitometry (CDens) after 1 year of orthokeratology (OK) lens wear in adolescents with myopia and to explore the associations among these parameters. This prospective study enrolled 40 eyes from 25 adolescents with myopia (mean age, 10.32 ± 1.73 years). Objective visual quality parameters, including the objective scatter index (OSI), Strehl ratio (SR), and modulation transfer function cutoff frequency (MTFcutoff), were assessed using the Optical Quality Analysis System II, while corneal wavefront aberrations and CDens were measured using the Pentacam system at baseline and at 1, 3, 6, and 12 months after OK lens wear. Longitudinal changes were analyzed using repeated-measures analysis of variance or the Friedman test, followed by Bonferroni-adjusted post hoc comparisons when appropriate. Compared with baseline, OSI increased significantly at 3, 6, and 12 months, and SR decreased significantly at 12 months, whereas MTFcutoff did not differ significantly across the five visits. The root mean square values of total aberration, higher-order aberrations, and lower-order aberrations of the anterior cornea and total cornea increased significantly at all follow-up visits, whereas posterior corneal aberrations showed no significant changes. CDens increased mainly in the anterior corneal layer and in the central and paracentral zones of the central layer and full-thickness cornea, whereas posterior-layer CDens decreased at 12 months. At 12 months, posterior-layer CDens showed moderate associations with SR and selected corneal aberration RMS values. One year of OK lens wear was associated with deterioration in selected objective visual quality parameters and sustained changes in corneal aberration patterns, while posterior CDens may provide complementary information for assessing long-term optical quality after OK lens wear.